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Hashimoto's & low T - Why would bottoming out TSH bring libido back?

Hi all, I'm 36 and have been working through the ropes of Hashi's for the past 3 years now. I first went in for fatigue and low libido and with the help of a local naturopath and some T3/T4 my thyroid seems mostly under wraps. My testosterone, as it turns out, is around 300 - that of an 80 year old man, according to my endocrinologist. My libido has been in the crapper for the past couple years, and a recent dating experience pretty much sealed the deal for me. I just don't get turned on much these days, if at all.

Why is this in the thyroid forums, you ask? At one point, my endo had prescribed 137mg of synthroid and within 6 months I was having some serious "hyper" symptoms including chest tightness, random panic attacks, insomnia... I actually ended up in the ER one night thinking maybe I was about to have a heart attack. However, for a couple weeks before I switched to my naturopath and my dosage went back to normal, I found myself noticeably more horny, thinking sexual thoughts, and finally feeling "up to speed" down yonder. It was a stark difference and I'm pretty bummed that I had to risk a heart attack to feel sexually normal.

My question is, what is it about too much thyroid that would return my libido to normal? Is this a Hashi's thing? Should I aim to get my TSH back into that range (was 0.08 at the time, and is now back to 1.86) or was the increased libido just symptoms of being hyper?

Just trying to connect all the dots. Those couple weeks felt like finally coming out of the clouds only having to go right back in again.

15 Replies

Sex hormones such as testosterone (in women oestrogen)and thyroid hormone interact and are linked so it is not surprising that with your thyroid hormone levels increasing that at the same time your libido makes and appearance it wouldnt surprise me if you testosterone levels had increased too.

You could slowly try to get your tsh closer to where it was when your libido came back. That is slowly slowly increase you t4 or t3 or both and keep a close eye on your symptoms off course to see where you optimal level is in order to get your libido back but not get hyper symptoms. It would probably be a fine balance and you'll have to decide whether it is worth the risks of the previous hyper experience symptoms possibly reappearing


Testosterone has been steadily on the decline since 2011 and is now at 300, so that hasn't been improving at all... I think I will try nudging the FT4 a bit higher and see if anything feels better. I'm currently on a synthetic compounded blend of slow release T3 and T4 (25/110)

TSH 1.86 (0.4-4.6)

FT4 0.76 (0.61-1.27)

FT3 3.12 (2.4-4.2)


I am female so can't comment on the testosterone but I agree with mcoates that you could try upping your thyroid meds slowly. My TSH is much lower than yours but I still have hypo symptoms, and my t4 is like yours, towards the bottom of the range. Don't go by the TSH - you may need to get that down below the official range to feel well. Of course if you start to get hyper symptoms you should decrease the dose again, but remember it takes 4-6 weeks for a change of T4 dose to fully take effect.


Are you sure you were hyper? What did A&E say, when you went fearing a heart attack. I hope they did an ECG and it was fine. I had exactly that scenario and afterwards went to a heart consultant and did one of those dreaded treadmill tests (I am not a gym type person!). I did well enough that he deduced I had no heart problems and the pain and tightness was muscular. Very common apparently.

If I were you I would do as suggested by others and gradually increase the dose. By the way, one way to know whether you are hyper or not is to take your temperature. If it is over normal, you probably are, unless you have some kind of virus. Mostly we hypos are low. It is a good idea to take your temp regularly whilst increasing, in order to have an idea of what it usually is for you and see if the new dose helps to raise it nearer to normal. Hope things get better soon.


Well, "sure" as in that was my best guess... TSH was at 0.08 at the time (FT4 was 0.9), I'd get random hart palps and racing even just walking to my car, hard time sleeping, bouts of chest tightness followed by intense anxiety (fear of dying kinda thing) out of the blue, cold sweats. It was no fun really and all went away after dropping the dosage back to 112. Of course, I totally lost the libido that I'd just regained. The emergency room did an EKG and everything was fine. Thanks for all your replies. I think I'm gonna float the idea of nudging the numbers with my naturopath for a while and see how close to that temporary libido boost I can get.


Sounds more hypo than hyper, possibly also low iron and ferritin. It might be as well to have the others checked that are always mentioned on this site, i.e. Vit D, B12, Folate and possibly cortisol.


I thought heart racing and panic attacks were hyper symptoms? Vit D was low at the time, has since stabilized. Also introduced Magnesium which (maybe coincidentally) seems to have mellowed out my heart.


They can be caused by either. Such fun, this thyroid business. The way to know is to take your temperature, as I said above. Also useful to buy a Blood pressure monitor, which will give your heart rate too, although annoyingly, heart rate can be high because you are hypo and the body is working hard to keep everything going. It is still good to know these things for yourself and then not worry so much. Omron is a good BP monitor. My GP uses the same one. Hope you manage to increase meds and feel better.

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I have a BP monitor, actually. And a thermometer. Could you detail what I ought to be doing, when, and what to look for?


Have you ever taken your temperature? It should be roughly where the red arrow shows but I have an old mercury one, so may be different. People vary but you are aiming to be roughly 37 c . Best to take it first thing in the morning, before doing anything. Do not move a muscle, except to stick it in your mouth. This is called your Basal temp. If it is way off normal you are definitely still hypo. If near to normal, say 36.7, you are probably not far off. It will rise during the day, highest in the afternoon. If taking it again, do not eat or drink or move around before doing so. Allow about 30 minutes after hot food/drink particularly

As for BP, just read the instructions and make a note of your readings. It can change dramatically through the day. You must rest before taking it. You will then begin to know what is right for your body. Everyone is different. Mine is pathetically low! Be your own doctor. You will soon know more than they do. Good luck!


Of course I've taken my temp! Haha. Just want to know what specifically to look for in terms of hypo/hyper benchmarking. Same for blood pressure.


They can definitely be caused by hypo i used to get palpitations all the time and anxiety is not unknown either. Insomnia is very well know amongst hypos i used to suffer from it for ages and can eventually settle out with increased meds. I would also suggest being careful with drinking alcohol as this will convert you testosterone to oestrogen as with already low testosterone levels you don't want to make them worse, it is the opposite of what happens in women.


They say the thyroid etc can have an effect on other hormones such as testosterone, but putting the low libido to one side for a second has there been a time when on medication when you've felt good in yourself other than the fact you're suffering from a low Libido? If there is and as a last resort it may be worth looking into some form of testosterone replacement therapy, especially if you've given the medication a fair crack for your thyroid. Then maybe worth treating your thyroid and your testosterone separately. Has your naturopath suggested any supplements you can take to improve your levels?

How true this is I don't know but it might be worth me mentioning this. I read that Robbie Williams, had been feeling fatigued and suffered from depression and he'd found something that had changed his life. Sometime later I read that he'd gone to a Endocrinologist in the states asking for Human Growth Hormone as it seems to be the in thing. The doctor ran some tests and apparently told him he didn't need HGH, he needed testosterone as he had the levels of an 80 year old man. He apparently now has testosterone jabs which have changed his life.

My testosterone levels tested 18months ago was 13.8 which I think equates to 400, apparently this is low to normal. Although my doctor had said my levels were fine and within range. I've just been put on Thyroxine, so am going to see what effect this will have on my testosterone levels first.


Hmm... It's been such a long and up-and-down slog, hard to say exactly. If I compare now vs. when I first went in to get this all looked at, major difference. In general, I'm awake and alert and functioning well. It's just this libido thing I'm dealing with and can't seem to separate it from the thyroid stuff. It all sorta seems to blur together. My endo said my T wasn't low enough to warrant putting me on supplements as he'd have to mega-dose me (78.5 free, 299 total). I'm going to get another referral hopefully this afternoon to do an MRI and check for pituitary issues. I had testicular torsion as a kid and surgery to repair the blood vessel as well as a few hard knocks to my forehead, so who knows. It'd be nice if I could rule out thyroid issues, but that small window I had (where I thought I was hyper) just felt so good libido wise that it's hard to go back. Confusing stuff.

PS: Edit to say, my naturopath had me try Maca for the libido stuff but after a few days of major diarrhea I woke up one morning dead tired. Did some research and discovered that Maca can interfere with thyroid function as well. So much for that.


You know... Come to think of it, right around the time of my supposed hyper symptoms, I was taking muira puama and catuaba extracts. Could be the thyroid was finally "in range" but these supplements wreaked havoc. I've tried dabbling with those supplements here and there since, and every time my chest got tight, sleep issues, etc. Maybe I oughtta put those to rest and try to drive my thyroid numbers back up again.


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